• R R Gaeta, A Macario, J B Brodsky, J G Brock-Utne, and J B Mark.
• Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, CA 94305-5115, USA.
• J. Cardiothorac. Vasc. Anesth. 1995 Oct 1;9(5):534-7.

ObjectiveTo evaluate postthoractomy analgesia in patients receiving lumbar epidural hydromorphone versus intrapleural bupivacaine.DesignA randomized, prospective, double-blind study.SettingA university-affiliated medical center.ParticipantsTwenty patients undergoing lateral thoracotomy for either pulmonary wedge resection, lobectomy, or pneumonectomy.InterventionNine patients received epidural hydromorphone, and 11 patients received intrapleural bupivacaine in the postoperative period.Measurements And Main ResultsSeverity of pain was assessed using a visual analog pain scale (VAPS) (0 to 100 mm) at 1, 3, and 5 hours. Patients receiving epidural hydromorphone had a statistically significant improvement in VAPS scores. Patients who received intrapleural bupivacaine did not achieve a significant reduction in pain scores. Nine of 11 patients in the intrapleural bupivacaine group had "failed" postoperative analgesia as defined by a VAPS greater than 30. Only 3 of 9 patients in the continuous epidural hydromorphone group had "failed" analgesia.ConclusionEpidural hydromorphone is superior to intrapleural bupivacaine in achieving satisfactory pain outcomes during the first 5 hours after thoracotomy.

29 keywords...

hide…